Introduction
A large number of people undergo coronary artery bypass
graft surgery (CABG) procedures every year because of its proven benefits of
survival, freedom from angina and improved heart condition. However, evidence suggests that majority of CABG
surgery patients suffer from a wide variety of emotions, a sense of
helplessness and sometimes a passive attitude. They along with their families
experience emotions like fear, anger, dependence, depression, and loneliness.
Some patients even become unnecessary dependent on their family merely because
they are scared. All these emotions can altogether alter their quality of life
and put such patients into a risk of activity intolerance. Not only this serves
as an obstacle in their early recovery but also for their self-esteem and
independence. Such patients need to
understand and work on their changing position without becoming depressed and
dependent. In this way, they can help themselves to accept this short-term
disability period and do what they can easily do. Nurses play a pivotal role
here because they offer care to the patients until patients become able to
care for themselves again. In this regard Virginia Henderson need theory is
analysed because according to her the nursing process is a use of the rational
approach to solve the problem. Nurses
should apply logical approach to help patients come out of their dependence and
feelings of helplessness following such an extensive procedure like CABA. This theory
also pays attention on the significance of patients’ independence so that
recovery of patients occurs after hospital discharge without any delay.
Health and quality of
life depends on recovery of patient following any surgical procedure and it’s
also the main motive of every nurse because according to this theory the care
provided by physician differs from that provided by the nurse. The theory stressed
the need of care for a patient till a time the patient can carry out his/her
work by own. The overall framework of this theory is anchored in encouraging and
increasing the patient’s independence. Since patients following CABA become
helpless and could barely walk a short distance, they need an encouraging nurse
to not only help them but also give them confidence to do their work
themselves. Henderson has therefore divided nursing activities into 14 parts, on
the basis of human needs, whereas a role of a nurse is divided into three parts
such as substitutive, complementary, and supplementary and main goal behind
this is to help the individual become as self-sufficient as possible. Nurses can
utilize this theory and help them meet their needs and to provide them with an
environment where patients can do activities independently. I am thus very
interested in this need theory by Virginia mainly due to its applications on
different aspects of the patients care in addition to my current position of
nursing. Henderson’s need theory can be functional for the
individualized care of the CABA patients.
Method
Gibb’s reflection model
is used in order to analyse this theory. This is selected because I wanted to
demonstrate the reflection of my feelings and knowledge I gained by reading
about this theory. I have reflected this theory considering the patients of
coronary artery bypass surgery and their present day needs. Critical reflection
is thought to be a precursor to changing learning that may bring about transformations
in individual understandings and likely actions. Nurses can especially utilize
critical reflection practices for keeping themselves busy in metacognition for
benefits of their patients (Eames & Coll, 2010). The critical reflection
offers several learning outcomes such as enhanced learning thinking, and evaluation
of self and communal methods (Smith, 2011).
General Overview
Virginia Henderson put forward this need theory in that time period
where needs of patients were the principal concern and that is why it is call
the needs theory. The Needs Theory revolves around the four metaparadigm, for
example, nursing, health, patient (person), and
environment. Nursing tackles incorporation of a care plan while health is a
well being of a patient in relation to their environment (Tourville and
Ingalls, 2003). The patient is his interactions and talk with the nurse to aid
communication. Henderson explains the idea of an individual or a person as a
composition of fourteen fundamental requirements that are further categorized
into psychological, spiritual, sociological and biological components. An
individual needs knowledge and vigour to carry out activities of daily life and
possess the basics for survival. The healthy and ill person needs help to
become independent, well, or die calmly and there is a link between body and
mind.
Environment could be a clinic, hospital, or house where communication
is taken place. In accordance with Henderson's idea environment involves a
person's bond with family and society participation. In addition, harm can
occur to a healthy individual by the environment via certain individual factors,
for instance age and as air pollution that can lead to sickness. Henderson
defines health as basic needs requiring an individual to work effectively.
This theory highlights the significance of endorsing health and
preventing illness since best possible health may be tough for some to attain. It
also converses about how factors like race, age, ability of mind and emotional
control affects the health and requirements of an individual.
In addition to these there are other three main
aspects of this model and these are: 1)
The nurse offers care to the patient till a patient becomes capable to care
himself: 2) A nurse dedicates themselves completely to the patient and 3) The
nurse must be knowledgeable at the college level in both art and science.
Analysis
Description
Virginia Henderson need
theory exclusively offers a set of definitions, schemes and interconnected ideas
that provides a systematic mean to look for events by recognizing relationships
(Mensik, Martin, Scott, & Horton, 2011). Henderson provided a nursing definition
due to the noted differences nursing was previously defined, both by the nurses
and society themselves. This conceptual model
follows the humanistic paradigm, in which it underlines the caring of the ill
and the helpless together with the dying ones. It emphasizes more on what every
nurse have to perform and who must they deal with and consequently involve the
reciprocal communication.
Feelings
With regard to patients who have undergone GABA, it is generally expected
that they should be able to; express aptitude to handle and requests for help
when required; show knack to resolve issues and take part at society level; avoid
developing negative attitude and activities toward themselves or others and exchange
necessitates and discuss with others to fulfil needs. Taking in consideration
of all this, Virginia Henderson need theory meet the criteria and gives
valuable knowledge and help to achieve the goals.
Evaluation
According to Geroge
(2011) the basic concept put forward by Henderson such as basic human needs, interaction-communication,
culture and biophysiology facilitates the theory to provide a dynamic coverage concerning
patients need. Despite having a number of benefits, this theory does not
provide a theoretical connection between physiological and other characteristics
of human beings. This theory although emphasizes nursing care but lacks to
demonstrate the influence that happens when nursing care is given. In other
words, it lacks explanation of relation between its fourteen constituent of
basic nursing care. It also does not include holistic approach that not only
includes emotional and physical needs of a person but also spiritual and
religious needs of a person (Tourville and Ingalls, 2003). One cannot say that
all people who have same requirements specified in this theory through fourteen
points are the only needs that humans require in getting health and for better
quality of life. With the present day advancements, there may be additional
needs that individuals are entitled to be offered by nurses.
The holistic approach
is one such need since it is particularly necessary in case of patients of CABA
because this approach supports patients further than their physical
requirements. Additionally, some patients
are spiritual and they may use their faiths and principles in dealing with
dependence, helplessness, pain and illness. In fact research has showed that
spiritual people are likely to have a more optimistic stance and a healthier
quality of life. In today’s world, healthcare providers also focus on balancing
their patients’ care by retrieving more spiritual basis of medicine.
Action
In the modern times holistic
approach is an important component of health care. Thus, lack of this important
part makes the need theory by Henderson outdated and does not fit aptly in
relation to CABA patients. Overall, Henderson need theory is relatively simple
nevertheless generalizable and requires further embellishment.
Literature Review
According to Parker
(2001) Henderson need theory values independence of a patient. The nursing care
facilitates the patients to do tasks themselves and take control of their needs
unaided and nursing care does so by giving and encouraging their strength,
supplementing their level of understanding, and enhancing their willpower to accomplish
so. If patient is still dependent, it means the basic aim has not achieved. Henderson
emphasizes that the nurse should know about their patients thoroughly with the
intention of knowing what he wants (Marriner-Tomey and Alligood 2006). Timber (2001) states that this theory is generally
complementary and adoptable for care and practice associated with nursing in a
variety of clinical settings. According Ahtisham and Jacoline (2015)
to need theory works to identify caring needs, convey and assess holistic
nursing care. Furthermore it can be related to any clinical settings and it can
assist qualified nurses to gather reliable and legitimate data regarding the
customers’ health status, which consecutively improve the quality of nursing
care offered to the patients.
Application
Henderson's Nursing need
theory is an ostentatious theory that can be used for several types of nursing.
Conclusion
The authenticity of any
profession is proven by its capability to create and apply assumptions and theory.
Although nurses enjoy an exquisite status in society, this profession has to put
forth great effort to declare itself as a highly esteem profession. In this
scenario, great deals of tough tasks pertaining to patients have to be
performed besides handling patients. The patients in critical care especially
of cardiac patients not only need typical nursing help but rehabilitation so
they can spend life independently. Henderson need theory particularly addresses
the needs of patient and explain nurses’ role effectively.
